Mod 3 MSN 621 Practice Quiz- Questions and Answers|
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A 65-year-old man comes in with a 4-week history of productive cough, weight loss, and low-
grade fever. His medical history is significant for diabetes mellitus, hypertension, and cataracts.
His family history is unremarkable. He returned from a business trip to Thailand about a month
ago. On physical examination, a few enlarged lymph nodes are in the cervical region. A chest x-
ray is done, and the diagnosis is established. Which of the following measures should be taken
before starting a 6-month treatment regimen? Check liver enzyme levels
The 32-year-old man presents with orange-colored tears and orange-red urine for one week. A
review of systems is positive for occasional heartburn. A month ago, he was diagnosed with
pulmonary tuberculosis (TB), for which he is taking isoniazid (INH), rifampin (RIF), pyrazinamide
(PZA), and ethambutol (EMB). On physical examination, his vital signs are within normal limits,
and lung sounds are decreased in the right upper lobe of the lung. The patient is worried that
his drugs are not working and that the infection has spread to his eyes, although he admits that
his TB symptoms have improved. What is the best next step in management? Reassurance
and patient education
A 40-year-old man who is homeless presents with subjective fevers and a productive cough for 3
months. A review of systems is positive loss of appetite and unintended loss of 22 lb (10 kg). He
denies smoking but reports drinking hard liquor almost daily since he was 16 years old. On
exam, his temperature is 99 °F (37.2 °C). Auscultation of the chest demonstrates bronchial
breath sounds and crackles in the right upper lobe. Laboratory testing reveals a WBC count of
4000/μL and an erythrocyte sedimentation rate of 45 mm/hour. His chest x-ray shows a cavitary
lesion in the right upper lobe and reticulonodular infiltrates. A purified protein derivative (PPD)
skin test is negative. Sputum microscopy demonstrates acid-fast bacilli (AFB). What is the best
management strategy? Treat the patient for presumed tuberculosis
A 34-year-old man presents with a persistent cough. A history of present illness reveals a
productive cough and night sweats. He has no significant past medical history. He is a refugee
from Central America. A chest x-ray demonstrates an upper lobe mass, and interferon release
assay is positive. He is started on a 4-drug antitubercular regimen. A 26-year-old medical
, professional is concerned as he was not wearing a mask while examining the patient. Purified
protein derivative (PPD) skin tests in the past were always negative, but now he has 15 mm of
induration. He does not report fever or cough. Which of the following is the best next step in
management? Chest radiograph
A 35-year-old woman presents to the employee health clinic for her annual physical
examination. They work as a nurse in the adult infectious isolation ward in the hospital with a
history of treating patients with tuberculosis. They have no known medical condition. Which of
the following will give a positive result for the test given to the patient? 10 mm of induration
or more
A 55-year-old man with a past medical history of hypertension, type 2 diabetes mellitus, and
prior alcohol use disorder presents to the clinic. He has recently been diagnosed with
Mycobacterium tuberculosis and is waiting to start medical therapy. The clinician discusses with
the patient beginning a monotherapy for latent tuberculosis. Which of the following tests
should be ordered before initiating treatment? Liver function tests
A 58-year-old man presents to the clinic with a recent diagnosis of mycobacterium tuberculosis
after complaining of chronic fatigue, fever, and weight loss for the last six months. Which of the
following agents would be best indicated to supplement his medical therapy to prevent drug
side effects? Pyridoxine (B6)
A patient presents to the clinic who is recovering from malaria. On physical and examination,
there is no significant finding. The patient is planning on going on a vacation and is worried
about the recurrence of the disease. He is interested in effective ways of preventing mosquito
bites while on vacation. Which of the following is true regarding techniques to prevent
mosquito bites? DEET is the most well studied and most commonly recommended repellant.
A patient is diagnosed with Lyme disease and started on doxycycline 100 mg PO BID for 4
weeks. After the first dose, the patient is worse with dizziness, shaking, and fever. What is the
cause of the change in the patient's condition? Jarisch-Herxheimer reaction
Latest Update 100% Verified
A 65-year-old man comes in with a 4-week history of productive cough, weight loss, and low-
grade fever. His medical history is significant for diabetes mellitus, hypertension, and cataracts.
His family history is unremarkable. He returned from a business trip to Thailand about a month
ago. On physical examination, a few enlarged lymph nodes are in the cervical region. A chest x-
ray is done, and the diagnosis is established. Which of the following measures should be taken
before starting a 6-month treatment regimen? Check liver enzyme levels
The 32-year-old man presents with orange-colored tears and orange-red urine for one week. A
review of systems is positive for occasional heartburn. A month ago, he was diagnosed with
pulmonary tuberculosis (TB), for which he is taking isoniazid (INH), rifampin (RIF), pyrazinamide
(PZA), and ethambutol (EMB). On physical examination, his vital signs are within normal limits,
and lung sounds are decreased in the right upper lobe of the lung. The patient is worried that
his drugs are not working and that the infection has spread to his eyes, although he admits that
his TB symptoms have improved. What is the best next step in management? Reassurance
and patient education
A 40-year-old man who is homeless presents with subjective fevers and a productive cough for 3
months. A review of systems is positive loss of appetite and unintended loss of 22 lb (10 kg). He
denies smoking but reports drinking hard liquor almost daily since he was 16 years old. On
exam, his temperature is 99 °F (37.2 °C). Auscultation of the chest demonstrates bronchial
breath sounds and crackles in the right upper lobe. Laboratory testing reveals a WBC count of
4000/μL and an erythrocyte sedimentation rate of 45 mm/hour. His chest x-ray shows a cavitary
lesion in the right upper lobe and reticulonodular infiltrates. A purified protein derivative (PPD)
skin test is negative. Sputum microscopy demonstrates acid-fast bacilli (AFB). What is the best
management strategy? Treat the patient for presumed tuberculosis
A 34-year-old man presents with a persistent cough. A history of present illness reveals a
productive cough and night sweats. He has no significant past medical history. He is a refugee
from Central America. A chest x-ray demonstrates an upper lobe mass, and interferon release
assay is positive. He is started on a 4-drug antitubercular regimen. A 26-year-old medical
, professional is concerned as he was not wearing a mask while examining the patient. Purified
protein derivative (PPD) skin tests in the past were always negative, but now he has 15 mm of
induration. He does not report fever or cough. Which of the following is the best next step in
management? Chest radiograph
A 35-year-old woman presents to the employee health clinic for her annual physical
examination. They work as a nurse in the adult infectious isolation ward in the hospital with a
history of treating patients with tuberculosis. They have no known medical condition. Which of
the following will give a positive result for the test given to the patient? 10 mm of induration
or more
A 55-year-old man with a past medical history of hypertension, type 2 diabetes mellitus, and
prior alcohol use disorder presents to the clinic. He has recently been diagnosed with
Mycobacterium tuberculosis and is waiting to start medical therapy. The clinician discusses with
the patient beginning a monotherapy for latent tuberculosis. Which of the following tests
should be ordered before initiating treatment? Liver function tests
A 58-year-old man presents to the clinic with a recent diagnosis of mycobacterium tuberculosis
after complaining of chronic fatigue, fever, and weight loss for the last six months. Which of the
following agents would be best indicated to supplement his medical therapy to prevent drug
side effects? Pyridoxine (B6)
A patient presents to the clinic who is recovering from malaria. On physical and examination,
there is no significant finding. The patient is planning on going on a vacation and is worried
about the recurrence of the disease. He is interested in effective ways of preventing mosquito
bites while on vacation. Which of the following is true regarding techniques to prevent
mosquito bites? DEET is the most well studied and most commonly recommended repellant.
A patient is diagnosed with Lyme disease and started on doxycycline 100 mg PO BID for 4
weeks. After the first dose, the patient is worse with dizziness, shaking, and fever. What is the
cause of the change in the patient's condition? Jarisch-Herxheimer reaction
